Osteoarthritis is a condition where cartilage between joints wears away, causing pain and stiffness. The knee joint connects the femur, tibia, fibula, and patella. It is stabilized by ligaments and contains cartilage menisci that absorb shock. Risk factors for osteoarthritis of the knee include heredity, overweight, injury, and alignment issues. Symptoms include pain, stiffness, and reduced function. Treatment involves education, exercise, weight loss, braces, medications, injections, and physiotherapy techniques like manual therapy and electrotherapies.
2. Definition:
Osteoarthritis (OA) is a condition in
which the cartilage between the joints
is wears away leading to pain and
stiffness.
American Academy of Orthopaedic Surgeon
A. INTRODUCTION
5. The knee joins of femur to the tibia, fibula
and also patella.
Tendons that stabilize the knee are:
(a)Anterior Cruciate Ligament: prevent femur
from sliding backward on the tibia (or tibia
sliding backward on the femur).
(b)Posterior cruciate ligament: prevents the
demur from sliding forward on the tibia (or
the tibia sliding backward on the femur).
(c)Medial and Lateral collateral ligaments:
prevent from sliding side to side.
Two C-shaped of cartilage that called medial
and lateral menisci that act as absorber.
Source: WebMD
10. Pathophysiology of knee OA
Damage at the more weight bearing articular
cartilage
Osteophytosis
Changes in subchondral bone
Synovitis
Thickening of the joint capsule
Source: J Musculoskeletal Neuronal interact 2006; 6(4):376-378
11. SIGN
Reduced range of joint movement.
Pain on movement of the joint or at
extremes of joint movement.
Joint swelling/ synovitis (warmth,
effusion, synovial thickening).
Periarticular tenderness.
Crepitus.
Clinical presentation
Source: http://www.patient.co.uk/doctor/osteoarthritis
12. Joint instability.
Muscle weakness/wasting around the
affected joint.
SYMPTOM
Pain with activities, relieve by rest.
Usually pain felt in or around the knee.
Joint stiffness in the morning or after rest.
Reduced function and participation
restriction
Source: http://www.patient.co.uk/doctor/osteoarthritis
13. Doctor’s management
Non – pharmacological management
1. Education and behavioral intervention
2. Weight loss
3. Exercise
4. Mechanical aids
Source: The Medical Journal of Australia
14. Pharmacological management
(i) Systemic drugs
Paracetamol
NSAIDS and cyclo-ocgenase-2-specific inhibitors
Glucosamine and chondroitin
Opioids
(ii) intra-articular injection
Viscosupplementation
Glucocorticoids
Topical analgesia
Source: The Medical Journal of Australia
15. 1. Exercise therapy
2. Hydrotherapy
3. Self management and education
4. Manual therapy or mobilization techniques
5. Joint protection and provision of walking
aids and splint or braces
6. Electrophysical agents (e.g. thermotherapy,
ultrasound and laser)
Physiotherapy’s management
Source: Australian Physiotherapy Association
16. 1. The American Academy of Orthopaedic Surgeon. (October 2007).
Arthritis of the Knee. Retrieved on April 19, 2013 from
http://orthoinfo.aaos.org/topic.cfm?topic=a00212
2. Arthritis Research UK. (n.d.). Which joints affected by osteoarthritis?
Retrieved on April 19, 2013 from
http://www.arthritisresearchuk.org/arthritis-
information/conditions/osteoarthritis/which-joints-are-affected.aspx
3. WebMD. (2005). Knee (Human Anatomy) images, functions, ligaments
and muscles. Retrieved on April 19, 2013 from
http://www.webmd.com/pain-management/knee-pain/picture-of-the-
knee
4. Wright Michelle. (2010). Osteoarthritis. Retrieved April 20, 2013 from
http://www.patient.co.uk/doctor/osteoarthritis
5. Osteoarthritis in the knee. (n.d.) retrieved April 20, 2013 from
http://healthpages.org/health-a-z/osteoarthritis-knee/
References
17. Online journal
1. Goldring, S.R. & Goldring, M.B..(2006). Clinical aspects, pathology and
pathophysiology of osteoarthritis. J Musculoskelet Neuronal Interact 2006; 6(4):376-
378. Retrieved April 19, 2013 from http://ismni.org/jmni/pdf/26/30GOLDRING.pdf
2. Grainger, R. & Ciccuttini, F.M..(2004). Medical management of osteoarthritis of the
hip and knee joints. Med J Aust 2004; 180 (5): 232-236. Retrieved April 20, 2013
from https://www.mja.com.au/journal/2004/180/5/medical-management-osteoarthritis-
knee-and-hip-joints
3. Australian Physiotherapy Association. (November 2005). Physiotherapy in the
management of the arthritis and musculoskeletal conditions. Retrieved on April 26,
2013 from
http://www.goforyourlife.vic.gov.au/hav/admin.nsf/Images/Physiotherapy_in_the_manag
ement_of_arthritis_Position_Statement.pdf/$File/Physiotherapy_in_the_management_o
f_arthritis_Position_Statement.pdf